Policy Clearinghouse

Community-Based Doulas



Community-based doulas are an effective state strategy to impact:

Community-based doulas are an effective strategy to increase attendance of health appointments; improve healthy birth outcomes such as preterm birth rate, low birthweight, and NICU admissions; foster nurturing and responsive parenting behaviors; and increase breastfeeding initiation. Community-based doulas are unique in their ability to empower and support birthing people, especially birthing people of color who are more likely to experience discrimination in traditional health care settings. The current evidence base does not provide clear guidance for state policy levers, but local level community-based doula programs have been rigorously studied and proven to be effective.

Community-based doulas provide families with support and knowledge throughout the entire perinatal period. These doulas specialize in culturally competent perinatal care that reflects the values and lived experiences of their clients. Community-based doulas are typically introduced to a birthing person during pregnancy and will attend the birth of the child and provide support during the entire perinatal period, including postpartum visits. Support from community-based doulas can include connection to community resources, patient empowerment, and lactation education.

Local organizations offering community-based doula services are already in place, but there are many options for states to strengthen the community-based doula workforce and increase access to doula services. These options include equitable Medicaid reimbursement, workforce training scholarships and grants, certification and training opportunities, and inclusion of doula representatives on state commissions and maternal mortality and morbidity review committees. Although strong causal evidence supports the effectiveness of community-based doula interventions, the evidence base does not currently provide clear guidance on the most effective method to implement community-based doula interventions statewide.  

Download the Complete Evidence Review

Community-Based Doulas Evidence Review (PDF)

Download the 2-Page Summary

Summary of the Rigorous Research on Community-Based Doulas (PDF)

Recommended Citation:
Prenatal-to-3 Policy Impact Center. (2023). Prenatal-to-3 policy clearinghouse evidence review: Community-based doulas (ER 23B.0923). Peabody College of Education and Human Development, Vanderbilt University.

September 2023

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